P-539 Background: During 2001, persons who attributed their health problems to environmental exposures, e.g. electromagnetic fields (EMF), were counselled in an interdisciplinary environmental medicine pilot project in the Basel area. Methods: All participants had a medical and a psychological-psychiatric examination and were visited at home by an environmental hygienist. High and low frequency EMF measurements were conducted at the homes of those participants who attributed health complaints to EMF. EMF were always measured on the bed and additionally in other rooms depending on duration of stay in the respective rooms and the concerns of the participants. The plausibility of a context of the health complaints and the EMF were discussed in joint project team case conferences. Plausibility was judged on the basis of the following criteria: EMF had to exceed a tenth of the Swiss threshold values to be considered in the case conference (low frequency: 10 V/m, 0.1μT, high frequency: 0.6 V/m). The exposure had to occur in an area where the participant spent at least several hours or more every day. Prerequisite was that the exposure occurred before the onset of symptoms. Results: 25 of 63 (40%) of participants suspected EMF as cause of their health complaints. All EMF measurements yielded fields below the Swiss threshold values. It is not possible to prove a causal relation of health complaints due to environmental exposures based on single case evaluations and currently, there is uncertainty about whether EMF can cause any health symptoms or not. In the present project, according to the thorough examinations and case discussions, in 8 of the 25 (32%) participants, at least one of the reported symptoms was regarded to be possibly connected to the EMF exposure. All symptoms concerned a reduction in well-being. In addition, psychiatric diagnoses did not exclude environmentally caused symptoms. 45% of the participants reported half a year after counselling that they had benefited from the project and their health problems had improved. Conclusions: Experience of this pilot project was that participants had highly complex problems. Thus, only an interdisciplinary team is likely to be able to adequately diagnose environmental related health problems and provide suitable advice to concerned persons. The evaluation interview showed that a large proportion of the participants benefited of the project. Although time-intensive, such an approach might be an effective way to counsel individuals with symptoms attributed to EMF.

P-503 Introduction: Higher temperatures than usual were recorded during Summer 2003 across Europe and have been related to an increased mortality rate in several countries including Switzerland. Specific causes of death during this summer are examined. Methods: Daily mortality data for years 1990 to 2003 were obtained from the Swiss Federal Statistical Office. Meteorological data for 20 different stations and for the same period were provided by MeteoSwiss. Excess mortality due to specific causes of death was defined as the difference between observed and predicted mortality (extrapolated results of a Poisson regression model for 1990 to 2002 adjusted by trend in mortality). Results: The table shows the excess mortality for specific causes. The proportions of excess deaths due to respiratory, neurological, metabolic diseases and external causes were above average, whereas those due to cardiovascular diseases and cancer were under. Occurrence of cardiovascular diseases was overall lower for 2003 than for of the preceding years. No excess was observed for psychiatric disorders. Deviations from predicted daily mortality due to respiratory diseases were significantly correlated with deviations from predicted maximum temperature up to a lag of 3 days (highest correlation with deviation of maximum temperature of the same day r=0.40 95% CI:0.21–0.63). For neurological causes the highest correlation was observed with deviation of maximum temperature of the day before (r = 0.30, 95% CI: 0.10–0.52) and for cancer with the deviation of maximum temperature of the same day (r = 0.37, 95% CI: 0.19–0.60). For cardiovascular diseases, the highest correlation was observed for the deviation of maximum temperature of three days before (r = 0.41, 95% CI: 0.23–0.64). No such association was observed for external causes of death.Table 1Discussion and Conclusion: Most of the excess deaths during the 2003 heat wave were due to respiratory, neurological and metabolic diseases and external causes. Relative excess death were below average for cardiovascular diseases but its deviation was associated to deviation in temperature. External causes such as accidents occurred in a proportion higher than in previous years but not related to deviation in temperature.

P-715 Background: During 2001, persons who attributed their health problems to environmental exposures were counselled in an interdisciplinary environmental medicine pilot project in the Basel area. For this counselling, congruence of patients’ and experts’ health-belief models is an important factor. Method: We assessed the medical, psychiatric and environmental background in every participant in an environmental medicine project and discussed the explanatory value of our findings for each reported symptom. High and low psychological stress was extracted from questionnaires (self assessment of psychological stress) and the experts’ joint case conference (expert assessment of psychological stress). Results: Overall, 46% of reported symptoms could be explained by psychiatric factors alone. However, every second participant had at least one symptom that could be plausibly explained by simultaneously occurring medical, psychological or environmental findings. Psychiatric disorders were frequent, but did not exclude environmentally caused symptoms. Evaluation of self and expert judgement of psychological stress yielded four subgroups: two concordant and two discordant assessments of high or low stress load. Differentiation of these subgroups yielded characteristic differences with respect to the number of psychiatric diagnoses, psychological conflicts, environmental exposures and burden of chronic (somatic) illness. Conclusion: Experience of this pilot project was that participants had highly complex problems. Evaluation of experts’ and self rated psychological stress yielded information with respect to factors that contribute to a characterisation of this patient group. Only an interdisciplinary structure including medical, psychiatric and environmental expertise is likely to adequately diagnose and advise persons with environmentally related symptoms. Importance of interdisciplinary assessments have been recognised internationally, e.g. by WHO's recommendation of counselling persons with symptoms attributed to electromagnetic fields (“electromagnetic hypersensitive persons”/ fact sheet no. 296 from December 2005). However, although the results of the pilot study raised great interest, the establishment of a permanent interdisciplinary counselling structure was not yet successful.